Q & A with Dr. David Cook

The future looks bright for adapting technologies to medical education. At ICRE 2014, there will be a panel discussion on what the emerging trends are, and how technologies might be harnessed for the purpose of educational use. But is there a cautionary tale to be told? ICRE recently sat down with Dr. David Cook, who will be co-leading the panel with Dr. Ali Jalali, for a reality check on the future.

What are some of the advantages and disadvantages of educational technologies?

Technology has given us increased capacity to do some things that were difficult before, but they bring some baggage that can be problematic at times. One of them is cost. As a general rule, educational activities involving cutting-edge technologies cost a lot of money and time to develop and implement effectively. But people have largely glossed over the cost or trivialized it. I know I’ve done that; I have minimized how much time I invested in building courses, or suggested that we could spread that cost over several years. But when it came down to it, every year I spent countless hours updating my courses. Where it might have taken me a couple of hours to put together a PowerPoint presentation and then an hour to deliver that lecture to a group of residents, I spent dozens of hours to turn that same one-hour lecture into a web module. I’m all for education technologies – I’ve been doing research in the field and using technologies in teaching for the past 12 years, and I wouldn’t have spent that time without believing in them – but they’re not going to solve the world’s problems.

Can you talk about the added values that technology brings to education?

With computers, learners can control the pace of instruction and access an online course from anywhere in the world at any time of day, so technologies offer great flexibility in the delivery of instruction. We can also use computers to analyze a student or a group of students, and use that information to tailor instruction to their individual needs (though it can be very expensive to do so). As we learn more about how people learn, it’s not just an issue of transmitting information, it’s the timing and order of information and the relative amount of information they receive at a given time. Technology gives instructors the ability to make sure that everyone is receiving optimally sequenced, optimally timed, and an optimal amount of instructional experiences that are necessary to achieve learning. Education technologies also offer the advantage of analytics: we can collect data to help us improve the instruction for the next go-round and to do longitudinal studies to better understand how learners learn. Computers aren’t the only solution – we can collect the information in other ways – but they make it easy to collect that information.

What is the reality check about educational technologies?

With all these added values, it’s not a slam dunk. Every time we use a computer we don’t have a guarantee that it will give us the control, the analytics, or the desired flexibility we want. Education technologies are expensive, sometimes prohibitively so, and tt’s a lot harder to collect information about the learner than one might initially think. We also have to be aware of the hype surrounding educational technologies. I have no problem with concept of the “flipped classroom” but the reality is that people have been talking about the idea for decades, they just haven’t used that buzzword until recently.

The other thing about developing online courses is that we have this impulse that it has to be perfect – it has to be seamless, it has to work flawlessly. You do have to have a certain level of technical quality and a good infrastructure, because with a computer-based course if the power goes off, there is no course, there is no backup. But I think we are going to have to acknowledge that as we develop online courses, we can’t always aspire to create the perfect course. In order to dramatically reduce the costs and improve the overall economics of online programming, we may just need to aim for “good enough” courses, rather than perfect courses.

What are you hoping people will come away with from the panel?

I would like people to walk out of the room feeling that educational technologies are a powerful tool and feeling a bit more empowered to use some of these technologies to their advantage. These are tools, and they’re one more tool in our toolbox. If I’m building a house, I don’t always need to use a power saw – but power saws are great when I do need a power saw. With these technologies, people can say “Now I have a power saw. I didn’t have a power saw before, so I’m going to add it to my toolkit and when I need it, I know it’s there. But in the meantime I’m comfortable using hammers and screwdrivers and traditional saws, and I will continue to use those for the time being.”

I also want people to keep reaching for the stars but have their feet solidly on the ground. These technologies are not cheap and are not going to be easy to implement. They’re going to require some infrastructure, faculty development, and an up front investment. But if people can walk out with ideas and visions of what’s possible while at the same time having a realistic conception of what this requires, that will be beneficial. We’re going to have to work together to figure out how to create high quality instruction that achieves our aims without bankrupting the education system.

David Cook is currently Professor of Medicine and Medical Education in the Mayo Clinic College of Medicine, Consultant in the Division of General Internal Medicine, and Associate Director of Mayo Clinic Online Learning.